Strep Pharyngitis

SOAP Note- Strep Pharyngitis

 

 

Institution

Common Illness Across the Lifespan-Clinical Practicum

Professor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SOAP NOTE- Strep Pharyngitis

SUBJECTIVE DATA

Patients ID: John Doe, Aged 25 years. Race: Native American, Gender: male, Date of Birth 12/01/1996, Marital status: married.

CC: “I have been experiencing a burning pain in my throat, fever and a feeling of weakness with high temperatures x 4 days.”

History of present illness: A 25-year-old male patient presents to the clinic today with a complaint of sore throat, red and swollen tonsils with white patches. The patient also complained of painful swallowing with associated fever, headaches, and a decreased appetite. The patient suggested that the condition worsens at night. The condition is also worsening while drinking and eating. He states that the pain is severe and rates 8/10 using the pain scale. He verbalized that he used medics to relent his condition other than ibuprofen (Advil). The patient reverts contacts with sick persons, but he reports that he attended a soccer tournament at his brother’s school, where he interacted with many people.

Review of Systems

General: The patient reported no weight loss, weakness, night sweats, chills, fatigue, or malice. However, he has been experiencing fever, mild pain, and decreased appetite.

HEENT: Head; He complains of mild headaches but reverts to light-headedness or dizziness. Eyes; Denies changes in vision, diplopodia, floaters, or excessive tearing, nor does he use glasses for corrective vision. Ears; He denies hearing changes, tinnitus, earache, or pressure. Nose; Denies rhinorrhoea, epistaxis, nasal polyps, recent sinus infections, nasal discharge, or postnasal drip. Mouth and Throat; He denied bleeding gums, toothaches, sores in the mouth, changes in taste, hoarseness in voice, or voice changes. However, he reports he has a sore throat, hence difficulties swallowing or chewing.

Neck: He reported swollen glands. He was negative for neck stiffness, masses, pain, or swelling in the neck.

Respiratory: He denied coughs, shortness of breath, wheezing, or respiratory distress. Cardiovascular: He denied chest pain, palpations, dyspnea, murmurs, or edema.

Gastrointestinal: The patients complained of decreased appetite and stomach upsets. He denied vomiting, diarrhea, or changes in bowel movement, heartburns, hematemesis, abdominal pain, or rectal bleeding.

Genitourinary: Denied urinary frequency, urgency, burning sensation, incontinence, or changes in colour or odour, haematuria, or urinary pattern. The patient’s male genitalia was negative for discharge, negative urine stream, testicular pain, or swellings.

Musculoskeletal: The patient denied pain in joints, swellings, stiffness, muscle pains, or weakness, back pain, or limitations in range of motions.

Neurologic: The patient denied having seizures or changes in memory.

Lymph: The patient reported swollen glands or tenderness.

Endocrine: The patient reverted heat intolerance, weight changes, or fatigue.

Hematopoietic: Negative for bruises or bleeding tendencies.

Psychiatric: The patient denied suicidal ideation, depression, or mental illness attacks.

Past Medical History: The patient reports that at childhood, he had been affected by strep throat and ear infections. At his adult life, he suggested that he is not bothered by any medical condition.

Surgical History: The patient suggested that he underwent a minor surgery at the age of 16 years for the removal of an appendix (Appendicitis). The patient reported that he has never been hospitalized with any medical condition, injuries, or accidents. The patient also suggested that he has never got a blood transfusion. Therefore, his overall health condition is typical.

Allergies: The patient reported that he was allergic to dust at his young life, but in his adult life he reports no allergy nor intolerance to drug, food, nor environment.

Medications: Ibuprofen (Advil).

Immunization: The patient reported that he is up to date with his immunizations and lastly, he reported that he got his flu, and yellow fever jabs in October.

Family History: The patient suggested that his paternal grandfather and grandmother are alive and healthy aged 92 and 86. His maternal grandfather deceased at the age of 80 due to chronic diabetes. He also suggested that his maternal grandfather died at the age of 60 in a road accident, but he was healthy. His parents are alive and healthy.

Social History: The patient is not married, but he lives in his apartment. He is sexually active and uses protection while copulating with his girlfriend. He is an intern at a finance company where he was recently employed. He is sober, though he takes wine occasionally. He is free from recreational drugs. He is a Christian and attends mass at the local church every Sunday.

OBJECTIVE DATA:

General: The patient is well groomed, nourished, alert and oriented, and logical in thought. His responses to queries are brief but logical.

Physical Exam: Temperature’s 101.2, Heart Rate: 121, Blood Pressure: 104/68, RR: 20, O2 sat; 99% on RA, Height: 155 lb, Weight: 5’7’, BMI: 25.2.

HEENT: Head; Normal cephalic and symmetric. The hair distribution and pattern are normal. Eyes; PERRLA, EOMI are conjunctiva pink, and no redness or drainage realized. Sees an optician every six months. Ears; External auditory canals were clear with no drainage. The tympanic membrane was pearly grey and intact with a good cone of light reflex bilaterally. Nose; The nasal turbinates are pink and moist, and he is free of nasal congestion. No discharge was noted, and was free of erythema and inflammations. Mouth and Throat; Oral mucosa is pink and moist with no lesions. The tongue midline is pink. The teeth were white and oriented with no bleeding gums.

Neck: The neck was supple with trachea midline. Tonsillar and anterior cervical lymphadenopathy and tenderness. The neck has no pain or stiffness.

Respiratory: The patients chest walls are symmetrical and his respiration is regular. The patient’s lungs are also clear to auscultation bilaterally.

Cardiovascular: The patient’s heart rate is normal and regular S1 & S2. No amble, strokes, or rumbles.

Gastrointestinal: The patients had no multitudes or hepatosplenomegaly. His bowel movements are normal in all the four quadrants of the abdomen. He was free of tenderness.

Genitourinary/ Gynaecological: The patient experienced a decreased appetite.

Musculoskeletal: The patient refuted joint stiffness, back pain, or dislocations.

Neurologic: The patient reports no seizures, paralyzes, syncope, or changes in memory.

Lymph/Heme: The patient refuted increased thirst or hunger, irregular temperatures, nor swollen glands.

Psychiatric: The patient reported no depression, sleeping challenges, anxiety, or mood disorientation.

Lab Tests

· Rapid Strep Tests – positive

· Centor score was applied while estimating the probability of acute streptococcal pharyngitis. The score was five suggesting streptococcal infection.

· Ant Streptolysin O (ASO) test to test for strep infections.

· Throat culture may also be done to test for strep viruses.

ASSESSMENT

Differential Diagnosis

Differential DX: Strep Pharyngitis (ICD-10-CM- J02.0) – Strep throat is a bacterial infection that can trigger a feeling of soreness or scratchy. If the disease goes untreated, it may result in kidney inflammation or rheumatic fever (Gold et al., 2020). This condition is most prevalent among children, but it can affect people of all ages (Gold et al., 2020). The condition’s signs and symptoms manifest in painful swallowing, fever, headaches, rash, nausea, or vomiting (Gold et al., 2020). The condition is caused by an infection by the bacterium Streptococcus pyogenes or group A streptococcus. The bacterium can be spread through saliva droplets, sneeze, or shared meals or drinks (Gold et al., 2020).

Differential DX: Infectious Mononucleosis (ICD-10-CM- B27.9) – Infectious Mononucleosis describes a group of symptoms that are usually caused by Epstein-Barr Virus (EBV), and it typically occurs in the teenagers, but does not have an age limit (Ishii et al., 2019). The virus is spread through saliva. However, when one gets the infection once, he cannot contract the condition again in life (Ishii et al., 2019). The condition manifests in the form of headaches, fatigue, muscle weakness, rash, night sweats, and swollen tonsils (Ishii et al., 2019). The differential was ruled out by the centor score of five and rapid strep test.

Differential DX: Influenza (ICD-10-CM- J11.1) – Influenza is a viral infection that negatively affects the respiratory system; the nose, throat, and lungs. The condition in most cases heals on its own, but its complications are severe (Hutchinson, 2018). The condition tends to be prevalent in people aged five years and below or above 65 years. It also affects persons with weak immune systems and Native Americans (Hutchinson, 2018). The symptoms of the condition are fever, chills and sweat, sore throat, eye pain, and runny nose or stuffy nose (Hutchinson, 2018). The differential will be ruled out by the tests done and the age limit of the patient.

Final Diagnoses

Differential DX: Strep Pharyngitis (ICD-10-CM- J02.0) – The patient will be diagnosed with Strep Pharyngitis as evidenced by the symptoms he had. The tests conducted also affirmed the tests.

Treatment Plan and Education

 

Differential DX: Strep Pharyngitis (ICD-10-CM- J02.0).

The condition can be treated by the use of antibiotics such as penicillin or amoxicillin. Therefore, the patient can take penicillin V 500 mg PO BID for 10 days or amoxicillin 500 mg PO BID for 10 days (Mustafa & Ghaffari, 2020).

Differential DX: Infectious Mononucleosis (ICD-10-CM- B27.9).

There are is no specific therapy for treating infectious mononucleosis since antibiotics do not function well against viral infections. The condition is managed through non-pharmacological approaches such as eating healthy diets and drinking plenty of fluids (Ishii et al., 2019).

Differential DX: Influenza (ICD-10-CM- J11.1).

The condition can be treated through the use of antiviral drugs such as Oseltamivir phosphate (Tamiflu) Peramivir (Rapivab) or Baloxavir (Xofluza). The patient can take Oseltamivir 75 mg two times a day for 5 days (Hutchinson, 2018).

Education

· The patient should be counselled to regular wash his hands.

· He should be counselled to cover his mouth when he coughs.

· He should also be counselled against sharing of personal items such as glasses and eating utensils.

 

References

Gold, J. A., Monnett, S. W., & Richmond, B. K. (2020). Peritonitis and Pyomyositis complicating strep pharyngitis. The American Surgeon, 000313482095149. https://doi.org/10.1177/0003134820951497

Hutchinson, E. C. (2018). Influenza virus. Trends in Microbiology26(9), 809-810. https://doi.org/10.1016/j.tim.2018.05.013

Ishii, T., Sasaki, Y., Maeda, T., Komatsu, F., Suzuki, T., & Urita, Y. (2019). Clinical differentiation of infectious mononucleosis that is caused by Epstein-Barr virus or cytomegalovirus: A single-center case-control study in Japan. Journal of Infection and Chemotherapy25(6), 431-436. https://doi.org/10.1016/j.jiac.2019.01.012

Mustafa, Z., & Ghaffari, M. (2020). Diagnostic methods, clinical guidelines, and antibiotic treatment for Group A streptococcal pharyngitis: A narrative review. Frontiers in Cellular and Infection Microbiology10https://doi.org/10.3389/fcimb.2020.563627

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Interpersonal Psychotherapy

  • In one page, discuss interpersonal psychotherapy (IPT) for depression: what it is, who get depressed, what it does, assessment phase, end stage, and how it help patient, why is recommended. give 3 references. APA format

It is estimated that more almost 7% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Institute of Mental Health, 2017). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to behavioral issues, adolescent substance abuse issues, and even physical ailments. For this Assignment, you examine a PTSD video case study and consider how you might assess and treat clients presenting with PTSD.

Assignment: Posttraumatic Stress Disorder

 

 

It is estimated that more almost 7% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Institute of Mental Health, 2017). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to behavioral issues, adolescent substance abuse issues, and even physical ailments. For this Assignment, you examine a PTSD video case study and consider how you might assess and treat clients presenting with PTSD.

 

To prepare:

· Review this week’s Learning Resources and reflect on the insights they provide about diagnosing and treating PTSD.

· View the media Presentation Example: Posttraumatic Stress Disorder (PTSD) and assess the client in the case study.

· For guidance on assessing the client, refer to Chapter 3 of the Wheeler text.

 

Note:  To complete this Assignment, you must assess the client, but you are not required to submit a formal comprehensive client assessment.

 

The Assignment

 

Succinctly, in 1–2 pages, address the following:

 

· Briefly explain the neurobiological basis for PTSD illness.

· Discuss the DSM-5 diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?

· Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.

·

Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content

Name: NRNP_6645_Week9_Assignment_Rubric

 

Excellent 90%–100% Good 80%–89% Fair 70%–79% Poor 0%–69%
Succinctly, in 1–2 pages, address the following: • Briefly explain the neurobiological basis for PTSD illness. Points: Points Range: 14 (14%) – 15 (15%) The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness. Feedback: Points: Points Range: 12 (12%) – 13 (13%) The response includes an accurate explanation of the neurobiological basis for PTSD illness. Feedback: Points: Points Range: 11 (11%) – 11 (11%) The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness. Feedback: Points: Points Range: 0 (0%) – 10 (10%) The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing. Feedback:
• Discuss the DSM-5 diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not? Points: Points Range: 23 (23%) – 25 (25%) The response includes an accurate and concise description of the DSM-5 diagnostic criteria for PTSD and an accurate explanation of how they relate to the symptomology presented in the case study. The response includes a concise explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates strong diagnostic reasoning and critical thinking skills. Feedback: Points: Points Range: 20 (20%) – 22 (22%) The response includes an accurate description of the DSM-5 diagnostic criteria for PTSD and an adequate explanation of how they relate to the symptomology presented in the case study. The response includes an explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates adequate diagnostic reasoning and critical thinking skills. Feedback: Points: Points Range: 18 (18%) – 19 (19%) The response includes a somewhat vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a somewhat vague or inaccurate explanation of how they relate to the symptomology presented in the case study. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates somewhat inadequate diagnostic reasoning and critical thinking skills. Feedback: Points: Points Range: 0 (0%) – 17 (17%) The response includes a vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a vague or inaccurate explanation of how they relate to the symptomology presented in the case study. Or, response is missing. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates poor diagnostic reasoning and critical thinking skills. Or, response is missing. Feedback:
• Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard” treatment from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners. Points: Points Range: 27 (27%) – 30 (30%) The response includes an accurate and concise explanation of one other psychotherapy treatment option for the client in this case study. The response clearly and concisely explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Feedback: Points: Points Range: 24 (24%) – 26 (26%) The response includes an accurate explanation of one other psychotherapy treatment option for the client in this case study. The response adequately explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Feedback: Points: Points Range: 21 (21%) – 23 (23%) The response includes a somewhat vague or incomplete explanation of one other psychotherapy treatment option for the client in this case study. The response provides a somewhat vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Feedback: Points: Points Range: 0 (0%) – 20 (20%) The response includes a vague and inaccurate explanation of one other psychotherapy treatment option for the client in this case study, or the treatment option is innappropriate. Or, response is missing. The response provides a vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Or, response is missing. Feedback:
·   Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached. Points: Points Range: 14 (14%) – 15 (15%) The response is supported by specific examples from this week’s media and at least three peer-reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached. Feedback: Points: Points Range: 12 (12%) – 13 (13%) The response is supported by examples from this week’s media and three peer-reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached. Feedback: Points: Points Range: 11 (11%) – 11 (11%) The response is supported by examples from this week’s media and two or three peer-reviewed, evidence-based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached. Feedback: Points: Points Range: 0 (0%) – 10 (10%) The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing. Feedback:
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. Points: Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria. Feedback: Points: Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. Feedback: Points: Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. Feedback: Points: Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Feedback:
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation Points: Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Feedback: Points: Points Range: 4 (4%) – 4 (4%) Contains 1 or 2 grammar, spelling, and punctuation errors. Feedback: Points: Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains 3 or 4 grammar, spelling, and punctuation errors. Feedback: Points: Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Feedback:
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. Points: Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors. Feedback: Points: Points Range: 4 (4%) – 4 (4%) Contains 1 or 2 APA format errors. Feedback: Points: Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains 3 or 4 APA format errors. Feedback: Points: Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Feedback:

Show Descriptions Show Feedback

Succinctly, in 1–2 pages, address the following: • Briefly explain the neurobiological basis for PTSD illness.–

Levels of Achievement: Excellent 90%–100% 14 (14%) – 15 (15%) The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness. Good 80%–89% 12 (12%) – 13 (13%) The response includes an accurate explanation of the neurobiological basis for PTSD illness. Fair 70%–79% 11 (11%) – 11 (11%) The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness. Poor 0%–69% 0 (0%) – 10 (10%) The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing. Feedback:

• Discuss the DSM-5 diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?–

Levels of Achievement: Excellent 90%–100% 23 (23%) – 25 (25%) The response includes an accurate and concise description of the DSM-5 diagnostic criteria for PTSD and an accurate explanation of how they relate to the symptomology presented in the case study. The response includes a concise explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates strong diagnostic reasoning and critical thinking skills. Good 80%–89% 20 (20%) – 22 (22%) The response includes an accurate description of the DSM-5 diagnostic criteria for PTSD and an adequate explanation of how they relate to the symptomology presented in the case study. The response includes an explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates adequate diagnostic reasoning and critical thinking skills. Fair 70%–79% 18 (18%) – 19 (19%) The response includes a somewhat vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a somewhat vague or inaccurate explanation of how they relate to the symptomology presented in the case study. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates somewhat inadequate diagnostic reasoning and critical thinking skills. Poor 0%–69% 0 (0%) – 17 (17%) The response includes a vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a vague or inaccurate explanation of how they relate to the symptomology presented in the case study. Or, response is missing. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates poor diagnostic reasoning and critical thinking skills. Or, response is missing. Feedback:

• Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard” treatment from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.–

Levels of Achievement: Excellent 90%–100% 27 (27%) – 30 (30%) The response includes an accurate and concise explanation of one other psychotherapy treatment option for the client in this case study. The response clearly and concisely explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Good 80%–89% 24 (24%) – 26 (26%) The response includes an accurate explanation of one other psychotherapy treatment option for the client in this case study. The response adequately explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Fair 70%–79% 21 (21%) – 23 (23%) The response includes a somewhat vague or incomplete explanation of one other psychotherapy treatment option for the client in this case study. The response provides a somewhat vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Poor 0%–69% 0 (0%) – 20 (20%) The response includes a vague and inaccurate explanation of one other psychotherapy treatment option for the client in this case study, or the treatment option is innappropriate. Or, response is missing. The response provides a vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Or, response is missing. Feedback:

·   Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached.–

Levels of Achievement: Excellent 90%–100% 14 (14%) – 15 (15%) The response is supported by specific examples from this week’s media and at least three peer-reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached. Good 80%–89% 12 (12%) – 13 (13%) The response is supported by examples from this week’s media and three peer-reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached. Fair 70%–79% 11 (11%) – 11 (11%) The response is supported by examples from this week’s media and two or three peer-reviewed, evidence-based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached. Poor 0%–69% 0 (0%) – 10 (10%) The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing. Feedback:

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–

Levels of Achievement: Excellent 90%–100% 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria. Good 80%–89% 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. Poor 0%–69% 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Feedback:

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation–

Levels of Achievement: Excellent 90%–100% 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Good 80%–89% 4 (4%) – 4 (4%) Contains 1 or 2 grammar, spelling, and punctuation errors. Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%) Contains 3 or 4 grammar, spelling, and punctuation errors. Poor 0%–69% 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Feedback:

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.–

Levels of Achievement: Excellent 90%–100% 5 (5%) – 5 (5%) Uses correct APA format with no errors. Good 80%–89% 4 (4%) – 4 (4%) Contains 1 or 2 APA format errors. Fair 70%–79% 3.5 (3.5%) – 3.5 (3.5%) Contains 3 or 4 APA format errors. Poor 0%–69% 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Feedback:

Total Points: 100

Name: NRNP_6645_Week9_Assignment_Rubric

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Experiences Implementing or Applying Nursing Theory into Practice

Experiences Implementing or Applying Nursing Theory into Practice

Discussion Topic

 

 

Discussion Prompt

Magnet-designated hospitals must have a theoretical model that guides care. Every staff member must be oriented on that theory and its application in the facility. As nursing scholars, you may be called upon to guide your colleagues in this adventure. In this exercise, describe any experience you have had in implementing a facility-designated theoretical model. If you have not, find an article that describes the implementation of a theoretical model in a facility and summarize the article for the class.

 

Expectations

Initial Post:

APA format with intext citations

Word count minimum of 250

References: 2 high-level scholarly references within the last 5 years in APA format.

Plagiarism free.

Turnitin receipt.

 

Note: My University uses Watson as the theoretical model for the program. This helps to reflect the concentration on caring that is a focus of the program. However, there are situations in which Watson’s predictions do not fit and other theories will be called upon to predict outcomes.

Each theorist predicted outcomes from a different perspective. Consider each of them as a tool in your professional toolbox. You will learn to use the appropriate tool for the job. If you wish to predict how the empathetic concern for another, care, will affect outcomes then you will use Watson. If you are discussing how a patient adapts to health issues and care, you will use Roy. If you explore how a person accomplishes self-care, you will use Orem. King discusses systems. Leininger explores culture. Nightingale explored the environment. Henderson explored the activities of daily living. Each theory has a place with none being more important than another.

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statistics in health care

Statistical application and the interpretation of data is important in health care. Review the statistical concepts covered in this topic. the significance of statistical application in health care. Include the following:

  1. Describe      the application of statistics in health care. Specifically discuss its      significance to quality, safety, health promotion, and leadership.
  2. Consider      your organization or specialty area and how you utilize statistical      knowledge. Discuss how you obtain statistical data, how statistical      knowledge is used in day-to-day operations and how you apply it or use it      in decision making.

Three peer-reviewed, scholarly or professional references are required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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Assessing And Treating Patients With ADHD

Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.

To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication      Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend      for the assessment and treatment of patients with ADHD.

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure      to include the specific patient factors that may impact your decision      making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your      response with clinically relevant and patient-specific resources,      including the primary literature.
  • Why did you not select the other two options provided in the      exercise? Be specific and support your response with clinically relevant      and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support      your response with evidence and references to the Learning Resources      (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan      and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your      response with clinically relevant and patient-specific resources,      including the primary literature.
  • Why did you not select the other two options provided in the      exercise? Be specific and support your response with clinically relevant      and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support      your response with evidence and references to the Learning Resources      (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan      and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your      response with clinically relevant and patient-specific resources,      including the primary literature.
  • Why did you not select the other two options provided in the      exercise? Be specific and support your response with clinically relevant      and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support      your response with evidence and references to the Learning Resources (including      the primary literature).
  • Explain how ethical considerations may impact your treatment plan      and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you      selected for this patient. Be sure to justify your recommendations and      support your response with clinically relevant and patient-specific      resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature

Case study : Psychopharmacologic Approaches to Treatment of Psychopathology (laureate-media.com)

Assessing and Treating Patients With ADHD

Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.

To prepare for this Assignment:

· Review this week’s Learning Resources, including the Medication Resources indicated for this week.

· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note:  Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature

 

1

 

 

C

ase

st

udy :

Psychopharmacologic Approaches to Treatment of Psychopathology

(laureate

media.com)

 

 

Assessing and Treating Patients With ADHD

 

Not only do children and adults have different presentations for ADHD, but males

and females may also have vastly different clinical presentations. Different people

may also respond to medication therapies differently. For example, some ADHD

medications ma

y cause children to experience stomach pain, while others can be

highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must

perform careful assessments and weigh the risks and benefits of medication

therapies for patients acro

ss the life span. For this Assignment, you consider how you

might assess and treat patients presenting with ADHD.

 

To prepare for this Assignment:

 

·

 

Review this week’s Learning Resources, including the Medication Resources

indicated for this week.

 

·

 

Reflect on

the psychopharmacologic treatments you might recommend for the

assessment and treatment of patients with ADHD.

 

The Assignment: 5 pages

 

Examine

 

Case Study: A Young Caucasian Girl with ADHD.

 

You will be asked to make

three decisions concerning the medication to prescribe to this patient. Be sure to

consider factors that might impact the patient’s pharmacokinetic and

pharmacodynamic processes

.

 

At each decision point, you should evaluate all o

ptions before selecting your decision

and moving throughout the exercise. Before you make your decision, make sure that

you have researched each option and that you evaluate the decision that you will

select. Be sure to research each option using the prima

ry literature.

 

Introduction to the case (1 page)

 

·

 

Briefly explain and summarize the case for this Assignment. Be sure to include the

specific patient factors that may impact your decision making when prescribing

medication for this patient.

 

Decision #1 (1 p

age)

 

·

 

Which decision did you select?

 

·

 

Why did you select this decision? Be specific and support your response with

clinically relevant and patient

specific resources, including the primary literature.

 

·

 

Why did you not select the other two options provided in

the exercise? Be specific

and support your response with clinically relevant and patient

specific resources,

including the primary literature.

 

·

 

What were you hoping to achieve by making this decision? Support your response

with evidence and references to th

e Learning Resources (including the primary

literature).

 

·

 

Explain how ethical considerations may impact your treatment plan and

communication with patients. Be specific and provide examples.

 

Decision #2 (1 page)

 

·

 

Why did you select this decision? Be specific

 

and support your response with

clinically relevant and patient

specific resources, including the primary literature.

 

1

 

Case study : Psychopharmacologic Approaches to Treatment of Psychopathology

(laureate-media.com)

 

Assessing and Treating Patients With ADHD

Not only do children and adults have different presentations for ADHD, but males

and females may also have vastly different clinical presentations. Different people

may also respond to medication therapies differently. For example, some ADHD

medications may cause children to experience stomach pain, while others can be

highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must

perform careful assessments and weigh the risks and benefits of medication

therapies for patients across the life span. For this Assignment, you consider how you

might assess and treat patients presenting with ADHD.

To prepare for this Assignment:

 Review this week’s Learning Resources, including the Medication Resources

indicated for this week.

 Reflect on the psychopharmacologic treatments you might recommend for the

assessment and treatment of patients with ADHD.

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make

three decisions concerning the medication to prescribe to this patient. Be sure to

consider factors that might impact the patient’s pharmacokinetic and

pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision

and moving throughout the exercise. Before you make your decision, make sure that

you have researched each option and that you evaluate the decision that you will

select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

 Briefly explain and summarize the case for this Assignment. Be sure to include the

specific patient factors that may impact your decision making when prescribing

medication for this patient.

Decision #1 (1 page)

 Which decision did you select?

 Why did you select this decision? Be specific and support your response with

clinically relevant and patient-specific resources, including the primary literature.

 Why did you not select the other two options provided in the exercise? Be specific

and support your response with clinically relevant and patient-specific resources,

including the primary literature.

 What were you hoping to achieve by making this decision? Support your response

with evidence and references to the Learning Resources (including the primary

literature).

 Explain how ethical considerations may impact your treatment plan and

communication with patients. Be specific and provide examples.

Decision #2 (1 page)

 Why did you select this decision? Be specific and support your response with

clinically relevant and patient-specific resources, including the primary literature.

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Improving Hand-off Report

Improving Hand-off Report

Student Names

 

 

 

Team Name and First/Last Names of Participants

Problem

Report (timing and hand off errors):  The unit manager of a medical surgical unit has observed that change of shift report takes greater than 45 minutes.  In addition, staff has complained that their peers do not include vital data (IV sites, dressing sites, DVT prevention measures….) in report leading to errors, leave patients in disarray, and leave tasks incomplete.  Our task is to propose a change that will address these issues.

Report (timing and hand off errors:  Unit managers observed that there was miscommunication between staff during shift report.  Often times leaving out important patient information as well as taking a significant amount of time to relay the information. Our goal it to offer a change that will address these issues.

Now here is our SWOT analysis starting off with Derrick talking about the strengths.

 

Majka

“Communication failures compromise patient treatment, care quality, and safety. It also leads to medical errors, the third leading cause of deaths in the United States” (Ghosh, et all., 2015)

“The varying parties and large amount of complex information included in patient handoff reports frequently contribute to informational gaps and omissions in the handoff report that can lead to sentinel events and patient hard” (Staggers & Blaz, 2013)

“Research has identifed handovers as a risky time in the care process, when information may be lost, distorted or misinterpreted (Borowitz et al 2008, Owen et al. 2009, Philibert 2009)

 

Report (timing and hand off errors):  The unit manager of a medical surgical unit has observed that change of shift report takes greater than 45 minutes.  In addition, staff has complained that their peers do not include vital data (IV sites, dressing sites, DVT prevention measures….) in report leading to errors, leave patients in disarray, and leave tasks incomplete.  Your task is to propose a change that will address these issues.

 

Increase of errors during patient hand-off report leading to missed information and incomplete tasks

Hand-off report time is taking a greater deal of time

Our task is to implement the use of SBAR as the standard hand-off report between shifts in order to reduce errors and decrease the time spent giving report.

2

SWOT

 

Strengths: Multidepartment focus addressing handoff report problems(Robins et al., 2017) Solutions shorten time taken in report while increasing quantity of pertinent information. (Stewart & Hand, 2017) SBAR is supported by the Joint Commision (Stewart & Hand, 2017) Proven error reduction due to use of SBAR tool. (Stewart & Hand, 2017) SBAR is an evidence-based hand-off tool (Eberhardt, 2014) Weakness Use of the tool requires education to reduce user error (Stacey Eberhardt 2014) Medical personnel have personal bias on giving report (Ghosh et al.,  2018) Some staff are unreceptive to change (Robins & Dai, 2017). Evaluating execution of report can be affected by observer bias (Robins & Dai, 2017)
Opportunities SBAR is inexpensive as a tool and will earn its cost in education by the reduction of sentinel events (Stewart, 2017) Improve patient handoff by implementing an evidence-based handoff tool in SBAR format  (Eberhardt, 2014) For continued nursing education in standardizing hand-off report (Ghosh et al., 2018). Threats Due to the variety of the change-of-shift reporting process, the findings of the study may not be applicable across similar settings (Ghosh et at., 2018). Some staff are unreceptive to change (Robins et al., 2017). Evaluating execution of report is subject to observer bias (Drach-Zahavy, 2014)  Small sample sizes from 2 studies: only one randomized control study (Stewart, 2017)

 

Strengths:

Multidepartment focus on addressing problems with handoff report (Robins et al., 2017)

Solutions manage to shorten time taken to give report while increasing the amount of pertinent information given in that time frame. (Stewart & Hand, 2017)

SBAR is supported by the Joint Commision (Stewart & Hand, 2017)

Error reduction due to use of SBAR tool. (Stewart & Hand, 2017)

SBAR is an evidence-based hand-off tool (Eberhardt, 2014)

Weakness (Wendy)

Use of the tool requires education for all staff to reduce user error (Stacey Eberhardt 2014)

Medical personnel have personal bias on how they want to give report (Ghosh et al.,  2018)

Healthcare worker disinterest in changing how they give report. (Robins et al., 2017).

Subjective approach to measuring a handover’s strategies might be subject to bias, as participants may behave differently in the presence of an observer.

Opportunities (ashley)

SBAR is inexpensive as a tool and will earn its cost in education by providers by the reduction of sentinel events (each of which carries a high expense). (Stewart, 2017)

Improve patient handoff by implementing an evidence-based handoff tool in Situation Background Assessment Recommendation (SBAR) format  (Eberhardt, 2014)

For continued nursing education in standardizing hand-off report (Ghosh et al., 2018).

Threats (Alma)

Due to the variety of the change-of-shift reporting process, the findings of the study may not be applicable across similar settings (Ghosh et at., 2018).

The acuity of patient injury and medical history can increase the amount of time for patient hand-off (Robins, 2017).

Small sample sizes from 2 studies: only one randomized control study (Stewart, 2017) and sample size of 200 handovers in 5 wards in another study(Drach-Zahavy, 2014)

3

Assessment

Inefficient communication during hand off report is a challenge to patient care. (Ghosh, et al., 2018)​

 

Communication error given during report increases risk of poor patient outcomes. (Stewart, 2017)

Hand off communication between medical personnel leads to an increase in medication errors, incomplete tasks, disorder, and eventually poor patient outcomes (Robins et al., 2015)​

 

According to The Joint Commission, communication errors have been among the top three leading root causes of reported sentinel events every year since 2004. (Stewart, 2017)

The information we had gathered from our assessment on giving report overall was –

1. Poor communication leads to poor patient outcome

2. The Joint Commission has stated communication errors has been the top 3 leading root causes of unanticipated major events in the healthcare setting that results in death or serious physical or psychological injury to a client which require immediate investigation by the health care facility since 2004

3. And now we will be talking about our Diagnosis.

 

 

Goal should comes from assessments (SMART (MEASURABLE))

Assessment will be bullet points of why is this a problem

Specific, measurable, attainable, realistic, timely

 

All RNs and assistive personnel will attend 1 or more in-services on the use of SBAR handoff report within three weeks.

During the same three week period, charge nurses and nursing management will include SBAR teaching in pre-shift meetings, encouraging staff to begin to practice using the SBAR template during report.  Following the three week introduction of SBAR to the staff, SBAR will be implemented on the unit for a trial period of 1 month with the goal of receiving ideas of how we can improve it from the staff at the end of the 1 month period.  At the end of the one month period, staff nurses and assistive personnel will be invited to discuss their experiences with SBAR, as well as any ideas they have to improve it, during pre-shift meetings, down-time during their shift, or via email with the nurse manager.

15 days into the trial month, as well as at the end of the trial month, the nurse manager will personally solicit input regarding SBAR from harvest nurses on the unit.

At the end of the 1 month trial period, metrics on sentinel events, falls, nosocomial infections, and other communication errors will be compared with the month prior to SBAR implementation and to the same month in the previous year. During the second month, a new SBAR form that includes select suggestions from staff will be used by those staff members while other staff members continue to use the known SBAR report. Communication errors, sentinal events, falls, nosocomial infections, et al will be compared between the two systems.

 

Majka

4

Diagnosis

Lack of standardization in report

Communication Barriers (Stewart & Hand, 2017)

Communication practices learned by various career stages of nurses (promise, momentum, harvest)

Different individual communication styles

Gaps in knowledge regarding lack of standardized reporting

 

A lack of standardization in report increases risk of error and poor patient outcomes

5

 

S.M.A.R.T. Goal

Use an evidence-based standardized hand-off report tool to reduce report times to less than 45 minutes while reducing report-based errors by 20% within 6-month period.

Precontempemplation: Nurse manager goes to charge nurses, harvest nurses, and harvest support staff with the SBAR template and asks them to sit with it for one week. He or she will ask for feedback from these individuals about implementing it on the unit.

Contemplation: Harvest nurses and support staff, and charge nurses spend a week with the SBAR template and consider its strengths, weaknesses, and or simply form an opinion around it.   Preparation: nurse manager introduces in-services on SBAR and charge nurses begin introducing the template during pre-shift meetings.

Action: Nurses and support staff begin using the template during all hand-off reports for a one month period. Nurse manager seeks input from harvest staff on ways to improve the system and attempts to include their input on a trial period, thereby extending the practice of the original SBAR for another month with most staff, and offering a personalization to those interested in improving the system.  Maintenance: Nurse manager compares statistics from the same time period one year ago, to the same length of time prior to using the SBAR report, and the data from the SBAR report compared with the modified SBAR report and presents the data to the staff at a staff meeting. At the meeting the nurse manager encourages public input and opinions on the SBAR report. If there is resistance, the manager asks that SBAR be continued in practice for a 3 month period in which he or she will personally receive report from individuals on their patients – helping those nurses who need it with ways to be more succinct. At this point, the report will have been used in practice for 5 months and will have become habit for many of the staff.

Alma

6

References

Drach-Zahavy A ; Hadid N. Nursing handovers as resilient points of care: linking handover strategies to treatment errors in the patient care in the following shift. J Adv Nurs. 2015; 71: 1135-1145

Ghosh, K., Curl, E., Goodwin, M., Morrell, P., & Guidroz, P. (2018). An Exploratory Study on how to Improve Bedside Change-of-Shift Process: Evidence from One Hospital Using Technology to Support Verbal Reporting. HICSS.

Marquis, B.L., & Huston, C.  (2011). Leadership roles and management functions in nursing: Theory and application (9th ed).  Lippincott, Williams, Wilkins.  ISBN: 978-1-4963-4979-8

Robins, H., & Dai, F. (2015). Handoffs in the Postoperative Anesthesia Care Unit: Use of a Checklist for Transfer of Care. AANA journal, 83 4, 264-8.

Stewart, Kathryn R., “SBAR, communication, and patient safety: an integrated literature review” (2016). Honors Theses. https://scholar.utc.edu/honors-theses/66

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Debriefings

  • Describe the case that defined you as a nurse.
  • What happened, how were you involved?
  • How does this case still affect you and your practice?
  • What steps have you taken to overcome the stress of this event? (Remember to protect patient privacy).
  • Explain the importance of debriefings.
  • If a debriefing would happen in your workplace who would be involved, what would be discussed, who would lead the debriefing, where would it take place?

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Delegation in Practice

Delegation in Practice

What does the New York State Board of Nursing say about Unlicensed Assistive Personnel and their role, and the role of the Registered Nurse? Describe the responsibilities of the Registered Nurse when delegating patient care tasks.

How does the ICU environment differ from a general medical-surgical unit as far as assigned responsibilities for Unlicensed Assistive Personnel?

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Polypharmacy

Polypharmacy is defined as being on 5 or more medicines, and is a major concern for providers as the use of multiple medicines is common in the older population with multimorbidity, and as one or more medicines may be used to treat each condition.

  • Discuss two (2) common risk factors for polypharmacy. Give rationale for each identified risk factor.
  • Discuss two interventions you can take as a Nurse Practitioner in your clinical practice to prevent polypharmacy and its complications.

using at least 2 evidenced-based, peer-reviewed references no older than 5 years.

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Healthy People Curriculum Task Force

In 2004, the Healthy People Curriculum Task Force emphasized that ” an essential element of any effort to change a health care system must be the education of future clinicians who will practice new approaches in new contexts”. Based on this statement, is there a need for healthcare professional education reform? To what end?

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